Mrs. Timaima Ditukana1, Ms Alvina Lata1, Mrs. Savneel Shivam Kumar1, Mrs. Ashlyn Datt1, Mrs. Sisilia Vocea Tuinidau1, Mrs. Ateca Dilolo1, Ms Ilisapeci Nabose Nabose1, Mr Ravi Naidu1, Mrs. Ana Suka1, Mrs. Tracey Young Sharma1, Mrs. Shammi Prasadad2, Mr Alipate Vakamocea3, Mrs. Kirsty Buising6, Mr Mathew Richards4, Mrs. Donna Comeron5, Mrs. Aneley Getahun Strobel7
1Ministry of Health and Medical Services, Suva, Fiji, Suva, Fiji, 2Australian Volunteer International, Suva, Fiji, 3Australia Support to Fiji Health Sector, Fiji Programme Support Facility, Suva, Fiji, 4Infection Prevention and Surveillance Service, the Royal Melbourne Hospital, Melbourne, Australia, 5Microbiological Diagnostic Unit, Public Health Laboratory, Department of Microbiology and Immunology, the University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia, 6The Royal Melbourne Hospital, Melbourne, Australia, 7 Department of Microbiology and Immunology, the University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
Biography:
Timaima Ditukana, a dedicated and compassionate Registered Nurse with over 6 years of professional experience, specializing in infection prevention and control and surgical nursing.
Committed to delivering high standard of patient care and safety, with a strong focus on evidence-based practices and continuous professional development.
Abstract:
Issue identified
Colonial War Memorial Hospital (CWMH) is Fiji's largest national referral hospital. In early 2022, CWMH saw a progressive increase in carbapenem-resistant organisms (CROs).
What was done to rectify the problem
In response to rising CROs, the infection prevention and control (IPC) team developed a Standard Operating Procedure (SOP) in November 2022 with Contact Precautions (CP) as the mainstay of IPC management to prevent onward transmission of CROs in the hospital. In March 2023, a CP compliance audit SOP was developed, audit tools were standardized, and staff received training. Audit results and staff feedback were used to identify gaps and guide follow-up training.
The results
From March 2023 to April 2025, 95 audits were conducted. Majority (77%) of staff observed were nurses. Overall, compliance with hand hygiene was 63% before donning gowns, 46% after removing gloves, and 77% after doffing gowns. Adherence rate to the correct sequence of donning was 74%. Between 2023 and 2025, compliance improved for donning gowns (69% to 74%) and gloves (67% to 96%). Doffing compliance also increased for gloves (71% to 87%) and gowns (60% to 70%). Shared equipment cleaning improved from 42% in 2023 to 100% by 2025. A shortage or inadequate supply of gloves and cleaning products was reported.
Conclusions
The audit process highlighted both areas of good practice and opportunities for improvement. While progress has been made, the shortage of consumables remains a challenge. Ongoing staff engagement, supported by monitoring and timely feedback, will be key to maintaining appropriate IPC practices.